Abstract：
We compared differences in the hemodynamic parameters of multiple surgical techniques for supravalvular aortic stenosis (SVAS). A three-dimensional model was reconstructed based on a patient\'s CT scan. Virtual McGoon, Doty, and Brom repairs were completed using computer-aided design (CAD). Hemodynamic parameters were calculated through computational fluid dynamics (CFD). The velocity profile and wall shear stress (WSS) showed the blood flow pattern. Energy loss (EL) and energy efficiency (EE) were calculated to estimate the cardiac workload. The perioperative blood flow ratio (BFR) of brachiocephalic vessels and coronary arteries was calculated. The preoperative flow velocity was abnormally high (> 5.0 m/s). High WSS was detected at the sinotubular junction (STJ), and its preoperative distribution in the aorta was uneven. High-speed flow disappeared after each of the three operations. The WSS distribution at the aortic root was consistent with the postoperative STJ structure of each operation. EL in the systolic phase decreased postoperatively (Original: 634 mW, McGoon: 218 mW, Doty: 278 mW, Brom: 255 mW). No significant difference in brachiocephalic BFR was detected among the different techniques. A slightly increased coronary BFR (Original: 7.56%, McGoon: 7.99%, Doty: 8.55%, Brom: 8.89%) was detected. McGoon, Doty, and Brom repair each effectively restored stable blood flow and greatly improved EE. The best WSS distribution and coronary blood supply were achieved after Brom repair due to its ability to reconstruct the symmetrical aortic root structure. CFD combined with a virtual operation is a promising method in surgical planning and optimization for SVAS.
摘要：
我们比较了瓣膜上主动脉瓣狭窄（SVAS）的多种手术技术的血流动力学参数差异。基于患者的CT扫描重建三维模型。虚拟McGoon,多蒂,和Brom维修是使用计算机辅助设计（CAD）完成的。通过计算流体动力学(CFD)计算血液动力学参数。速度分布和壁切应力（WSS）显示了血流模式。计算能量损失（EL）和能量效率（EE）以估计心脏工作负荷。计算围手术期头臂血管和冠状动脉的血流量比（BFR）。术前流速异常高（>5.0m/s）。在窦管连接处（STJ）检测到高WSS，术前主动脉分布不均。在三个操作中的每一个之后,高速流动消失。主动脉根部的WSS分布与每次手术的术后STJ结构一致。收缩期EL术后降低（原始：634mW，McGoon:218mW,Doty:278mW,Brom：255mW）。在不同的技术中，没有检测到头臂BFR的显着差异。冠状动脉BFR略有增加(原始:7.56%,McGoon：7.99%，Doty：8.55％，Brom：8.89%）被检测到。McGoon,多蒂,和Brom修复各自有效地恢复了稳定的血流量并大大改善了EE。由于能够重建对称的主动脉根部结构，因此在Brom修复后可获得最佳的WSS分布和冠状动脉血液供应。CFD与虚拟手术相结合是SVAS手术计划和优化的一种有前途的方法。
